It's been a sore spot for the U.S. for years. Despite living inthe richest country on earth with the most expensive health caresystem, Americans are less healthy and live shorterlives than people in a number of countries that spend far less onhospitals, doctors and medicine.

A comprehensive look at the U.S. health care system by theKaiser Family Foundation and the Peterson Center on Healthcareshows that while the U.S. bests "comparable countries" on a handfulof important health care metrics, it lags behind its peers in farmore ways.

Among the measures in which the U.S. is a leader in the pack, asof 2013:

• Mortality rate for breast and colorectal cancers.

• 30-day in-hospital mortality rate for acute myocardialinfarction and ischemic stroke.

• Hospital admission rate foruncontrolled diabetes.

• Wait time for specialists.

The U.S. performs on par with other first-world nations when itcomes to cervical cancer survival rates, in-hospital mortalityrates for hemorrhagic strokes.

The list of ways in which the U.S. underperforms, however, ismuch longer and includes many more general metrics. Here are someof the highlights:

• Overall mortality rate.

• Life expectancy at birth.

• Hospital admission rates for asthma, congestive heartfailure, diabetes short term complications.

• Trauma during vaginal delivery.

• Use of emergency room for non-emergencies.

• Wait times for primary care physicians and urgentcare.

• Cost-related access barriers.

Cost-related access barriers to health care is the issue thatthe study suggests is likely underpinning many of the otherproblems facing U.S. health. For instance, while 37 percent ofAmericans reported cost barriers to health care in 2013, only 4percent of United Kingdom residents said the same.

Blaming costs is certainly nothing new; most other developedcountries provide free or near-free care, a fact that has beenregularly highlighted by those who have pushed for universal healthcare policies in recent years here.

The data comes from 2013, before the implementation of thePatient Protection and Affordable Care Act, which has alreadydramatically dropped the uninsured rate. Thebrief does not suggest how the PPACA might impact health outcomesin the future.